Should You Boost Your Choline?

Choline is a vitamin-like nutrient, and in health-food stores and on the Internet many claims are made for its potential benefits.

The National Academy of Sciences designated choline as “essential” and suggested specific daily intakes in 1998. It’s called “essential” because, though the liver manufactures some choline, most people need to get it from foods to stay healthy. Many foods supply it, with egg yolks, liver, and meat being the best sources (see below for others).

Choline is also a key component of lecithin (phosphatidylcholine), a fat-like substance found in our cells and sold as a diet­ary supplement. Because lecithin is an emulsifier—that is, it helps disperse fat particles in water and keeps them from separating—small amounts (derived from soy or eggs) are often added to foods such as ice cream, chocolate, and margarine to provide texture.

Choline claims: yes, no, maybe

Related to the B vitamins, such as folate and B12, choline plays many essential roles in the body. Notably, it is needed for the synthesis of acetylcholine, a key neurotransmitter, as well as lecithin, which helps maintain cell membranes, transmit nerve impulses, process fat and cholesterol, and perform other tasks.

Choline is essential for brain development in the fetus. Some studies have found that lab animals exposed to supplemental choline before birth have better brain function as they age. There’s also some evidence that people who consume lots of choline very early in life may be more likely to retain mental abilities as they age. Human milk supplies choline; infant formula is fortified with it.

Pregnant women with a low blood level or intake of choline are at higher risk for having children with neural tube defects.

Choline and lecithin, it's claimed, reduce blood cholesterol and heart disease. But studies have yielded inconsistent results, and some have actually found that they can boost LDL ("bad") cholesterol and trigylcerides.

It’s often claimed that choline or lecithin supplements help prevent memory loss, Alzheimer’s disease, depression, and various neurological disorders, but evidence is lacking. Studies in which older people or older lab animals were given extra choline have not found cognitive benefits.

They are also promoted as a treatment for liver disease, cancer, Parkinson’s disease, and HIV/AIDS, and as a way to build muscle. The clinical evidence is weak or nonexistent.

Stick to eggs and other foods

The recommended daily intake for choline is 425 milligrams for women, 450 for pregnant women, and 550 for men and breastfeeding women. A balanced diet should supply enough choline for most people, though strict vegetarians and older people tend to get less.

Pregnant and nursing women should make sure they consume choline-rich foods (rather than choline supplements). Some multivitamins contain small amounts. You don’t need supplements of choline or lecithin. Very high doses can cause low blood pressure, nausea, gastrointestinal upset, abnormal results on liver function tests, and a fishy body odor.